Home health care serves millions of patients in the United States, with substantial differences in Medicare use, visit volume, reimbursement, and workforce conditions across locations. The figures below combine 2022 national agency and patient measures, May 2024 wage data, 2024–2034 employment projections, and CMS Medicare home health utilization reported for calendar year 2021.
Contents
- National home health care snapshot
- Medicare utilization by state and territory
- Where patient volume is highest
- Reimbursement and visits per patient
- Workforce wages
- Employment outlook
National home health care snapshot
The CDC FastStats figures provide a broad view of the U.S. home health care system in 2022:
- The United States had 11,500 home health agencies.
- 83.5% of home health agencies had for-profit ownership.
- 3.3 million patients received and ended home health care during the year.
These measures describe different parts of the system. The agency count measures organizations, the ownership figure describes the operating structure of those agencies, and the patient figure counts people who both received and ended home health care during 2022. They should not be treated as a count of all people receiving care at any point during the year.
The national figures also differ in measurement period from the CMS state utilization data below. CMS reports Medicare home health agency utilization for calendar year 2021, while the CDC measures above refer to 2022. The workforce wage data are from May 2024, and the employment figures are projections covering 2024 through 2034.
Medicare utilization by state and territory
CMS reported Medicare home health reimbursement, patients, visits, average reimbursement per patient, and visits per patient for calendar year 2021. The measures show how widely utilization varied across the reported locations.
| Location | Patients | Visits | Average reimbursement per patient | Visits per patient |
|---|---|---|---|---|
| Alabama | 57,686 | 1,522,345 | $4,931 | 26 |
| California | 336,346 | 9,380,800 | $8,033 | 28 |
| Florida | 282,932 | 8,240,608 | $5,242 | 29 |
| Louisiana | 51,153 | 1,555,059 | $6,080 | 30 |
| Nevada | 29,744 | 962,107 | $7,658 | 32 |
| Oklahoma | 60,927 | 2,210,523 | $6,952 | 36 |
| Texas | 232,259 | 8,016,667 | $6,947 | 35 |
| Utah | 23,428 | 765,882 | $4,940 | 33 |
The full location-level figures show a wide range. Patient counts ran from 157 in Saipan and 233 in the U.S. Virgin Islands to 336,346 in California. Among the states, California had the largest reported Medicare home health patient count, followed by Florida with 282,932 and Texas with 232,259. New York reported 149,229 patients, while Illinois reported 132,904 and Pennsylvania reported 125,654.
The CMS source reports 4,367 patients in Puerto Rico, 785 in Guam, 4,604 in North Dakota, and 5,871 in South Dakota. These figures are included to keep geography explicit: the CMS table covers states as well as territories and other jurisdictions, and the smallest totals are not directly comparable with the largest state totals in scale.
Where patient volume is highest
California’s 2021 Medicare home health utilization included 336,346 patients and 9,380,800 visits, with $2,701,725,257 in reimbursement. Florida had 282,932 patients, 8,240,608 visits, and $1,483,203,698 in reimbursement. Texas had 232,259 patients, 8,016,667 visits, and $1,613,616,328 in reimbursement.
Other high-volume locations included New York, with 149,229 patients and 3,330,935 visits; Illinois, with 132,904 patients and 3,174,094 visits; and Pennsylvania, with 125,654 patients and 2,855,512 visits. Massachusetts reported 105,781 patients and 2,448,431 visits, while Ohio reported 98,607 patients and 2,351,176 visits.
The next group included Virginia, with 92,970 patients and 2,171,324 visits; North Carolina, with 91,095 patients and 1,946,886 visits; Michigan, with 89,546 patients and 1,872,595 visits; New Jersey, with 79,577 patients and 1,523,316 visits; Georgia, with 76,209 patients and 1,803,137 visits; and Maryland, with 69,013 patients and 1,407,309 visits.
Several states reported between 50,000 and 67,000 patients: Tennessee had 66,698; South Carolina had 64,097; Oklahoma had 60,927; Alabama had 57,686; Mississippi had 53,349; Indiana had 52,660; Louisiana had 51,153; and Missouri had 50,979. These counts are CMS Medicare utilization measures for 2021, not estimates of every home health patient in each location.
Reimbursement and visits per patient
The CMS data also show differences in reimbursement and service intensity. Average reimbursement per patient ranged from $2,814 in Puerto Rico to $10,057 in Saipan. Among states, South Dakota reported $3,547 per patient, North Dakota $3,910, Montana $3,990, Missouri $4,037, and Iowa $4,095. At the higher end, California reported $8,033, Nevada $7,658, Oklahoma $6,952, Texas $6,947, and Louisiana $6,080 per patient.
Reported visits per patient ranged from 17 in the U.S. Virgin Islands to 39 in Saipan. Among states, Missouri, Montana, and South Dakota each reported 19 visits per patient. Hawaii reported 19 as well. New Jersey reported 19, while Arizona, Maryland, New Hampshire, North Carolina, Oregon, and Vermont each reported 20 or 21 visits per patient.
Higher reported visit rates included 30 visits per patient in Louisiana, 32 in Nevada, 33 in Utah, 35 in Texas, and 36 in Oklahoma. The CMS figures show utilization patterns, but they do not by themselves explain why reimbursement or visit frequency differed among locations.
Additional state figures illustrate the middle of the range. Connecticut reported 40,228 patients, 1,046,345 visits, $5,539 per patient, and 26 visits per patient. Kentucky reported 45,666 patients, 1,073,892 visits, $4,898 per patient, and 24 visits per patient. Washington reported 46,578 patients, 959,308 visits, $5,691 per patient, and 21 visits per patient. Arizona reported 46,782 patients, 948,532 visits, $4,647 per patient, and 20 visits per patient.
The reimbursement totals also varied substantially. California reported $2,701,725,257, Texas $1,613,616,328, Florida $1,483,203,698, New York $805,695,915, Illinois $754,952,977, Pennsylvania $589,324,390, Massachusetts $587,579,009, and Ohio $448,405,594. Smaller totals included $778,023 in the U.S. Virgin Islands, $1,578,927 in Saipan, and $5,983,496 in Guam. These are reported reimbursement amounts for Medicare home health utilization in 2021.
Workforce wages
The BLS Occupational Outlook Handbook reported a median annual wage of $34,900 for home health and personal care aides in May 2024. The wage distribution was broad: the lowest 10% earned less than $25,600, while the highest 10% earned more than $44,190.
The percentile figures describe the national wage distribution for the occupational group identified by BLS. They are not the same measure as Medicare reimbursement per patient, and reimbursement should not be interpreted as an aide’s wage. Reimbursement reflects payments associated with covered home health utilization, while the BLS figures describe employee earnings.
For readers comparing the two types of data, the measurement dates are important. The CMS reimbursement and visit measures are for calendar year 2021. The BLS wage measures are from May 2024. A direct comparison across those years would not establish a trend because the datasets measure different subjects and use different reporting periods.
Employment outlook
BLS projected 17% employment growth for home health and personal care aides from 2024 to 2034. The agency also projected about 765,800 openings per year, on average, over that decade. This annual openings figure is a projection of openings, not a count of newly created positions alone.
Employment of home health and personal care aides was projected to rise from 4,347,700 in 2024 to 5,087,500 in 2034. The reported difference is 739,800 jobs over the projection period. These are forecasts rather than completed employment counts: the 2024 figure is the starting point used in the projection and the 2034 figure is the projected level.
The workforce outlook sits alongside the 2022 CDC measure of 3.3 million patients who received and ended home health care, but the figures should not be combined. The CDC patient measure covers people receiving and ending care during 2022, while the BLS employment figures cover an occupational group that includes home health and personal care aides. Different definitions, periods, and populations prevent a simple patient-to-worker calculation from these figures alone.
For practical interpretation, the available statistics describe a large and geographically varied service system: 11,500 U.S. agencies in 2022, a predominantly for-profit ownership structure, millions of patients receiving and ending care, substantial state-level variation in Medicare visits and reimbursement in 2021, and a projected need for a larger aide workforce through 2034. Each finding should be read with its source, geography, definition, and measurement period attached.